Why is Calcific Tendonitis So Painful

Table of Contents

• Understanding Calcification of the Shoulder Tendon
• Risk Factors and Causes of Calcific Tendonitis
• Symptoms of Calcific Achilles Tendonitis
• Diagnosis of Calcific Tendonitis
• Treatment Options for Calcific Tendonitis
• Long-Term Effects of Calcific Tendonitis
• Case Study: Successful Recovery
• Factors Influencing Long-Term Outcomes
• The Importance of Early Intervention
• Preventing Further Complications
• Managing Chronic Pain with Calcific Tendonitis
• When to Seek Medical Help
• Frequently Asked Questions

Understanding Calcification of the Shoulder Tendon

Calcification of the shoulder tendon, often referred to as calcific tendonitis, is a condition characterized by the accumulation of calcium deposits in the tendons of the shoulder, particularly affecting the rotator cuff. The condition occurs in less than 10% of patients with shoulder pain, making it relatively rare. This buildup can lead to inflammation, pain, and restricted movement.

The exact cause of calcific tendonitis is not fully understood, but it is often associated with degeneration of the tendon tissue, repetitive strain, or injury. Calcium deposits form as part of degenerative calcification and reactive calcification processes, involving the deposition of calcium phosphate crystals within the tendon. Calcific tendonitis typically progresses through three stages: formative, resting, and resorptive.

Symptoms typically include severe shoulder pain, especially during movement, and may also involve swelling and tenderness in the affected area [[1]](LINK 1).

Risk Factors and Causes of Calcific Tendonitis

Calcific tendonitis is a painful condition that often targets the shoulder joint, leading to severe pain and reduced mobility. While the precise cause remains unclear, several risk factors have been identified that increase the likelihood of developing this condition. Age is a significant factor, with most cases occurring in individuals between 40 and 60 years old. Women are slightly more prone to calcific tendonitis than men. Repetitive strain on the shoulder, especially from overhead activities or certain occupations, can also contribute to the development of calcium deposits in the rotator cuff tendons. Additionally, underlying medical conditions such as thyroid disorders and diabetes are associated with an increased risk. These calcium deposits can trigger inflammation and pain in the rotator cuff, making everyday movements difficult and uncomfortable. By understanding these risk factors, individuals can take proactive steps to protect their shoulder health and seek early intervention if symptoms of this painful condition arise.

Symptoms of Calcific Achilles Tendonitis

Patients with calcific tendonitis may experience a variety of symptoms, including:

• Severe Shoulder Pain: Acute pain with sudden onset is common, especially during acute calcific tendinitis. This can cause severe or significant discomfort, often worsening with movement or at night.
• Limited Range of Motion: Difficulty lifting the arm or performing overhead activities.
• Swelling and Tenderness: Noticeable swelling around the shoulder joint.
• Muscle Weakness: Weakness in the shoulder and arm due to pain and inflammation.

Diagnosis of Calcific Tendonitis

Diagnosing calcific tendonitis typically begins with a clinical diagnosis based on symptoms and physical examination, but imaging studies are required for confirmation. Healthcare providers may use X-rays to identify calcific deposits in the tendons, including both large and small calcific deposits. Magnetic resonance imaging is particularly useful for evaluating calcific deposits and associated tendon pathology, while ultrasound is effective for detecting small calcific deposits. Imaging can also reveal the resting phase of the disease, where calcific deposits appear homogeneously dense and chalk-like on radiographs. A detailed medical history and symptom review are essential for accurate diagnosis and treatment planning.

Treatment Options for Calcific Tendonitis

Conservative Treatments

• Rest and Activity Modification: Avoiding activities that exacerbate symptoms helps reduce stress on the Achilles tendon.
• Physical Therapy: Exercises to improve flexibility and strengthen the calf and ankle muscles. Eccentric exercises, such as controlled heel-drop movements, are a key component of rehabilitation for Achilles tendinopathy.
• Pain Management: NSAIDs or corticosteroid injections to reduce inflammation and pain. Conservative treatments are aimed at alleviating the patient’s pain symptoms, which are often caused by chemical irritation from calcium deposits.
• Heat/Ice Therapy: Applying heat or ice to alleviate pain and swelling.
• Heel Lifts: Heel lifts are orthotic devices that can decrease tension on the Achilles tendon, especially in cases of insertional Achilles tendinitis, helping to alleviate pain.
• Supportive Shoes: Supportive shoes, including softer or open-back designs, can help minimize tendon irritation and reduce strain on the Achilles tendon.
• Shoe Wear Modification: Shoe wear modification is an important part of conservative management, helping to alleviate pain and manage symptoms alongside other therapies.

Prolotherapy

In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat calcification of the shoulder tendon.

Published research has proven its pain-relieving, anti-inflammatory, and regenerative benefits.

Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with calcification of the shoulder tendon.

As prolotherapy is helping to treat the root cause of calcification of the shoulder tendon, it is deemed to be a permanent fix, preventing the symptoms from returning [4].

Other Interventions

• Extracorporeal Shock Wave Therapy: A non-invasive treatment that uses sound waves to break down calcium deposits and stimulate tendon healing.
• Surgery: In severe cases, surgical intervention may be necessary to remove calcium deposits and repair damaged tendons.

Long-Term Effects of Calcific Tendonitis

While many individuals experience relief from symptoms with appropriate treatment, some may face long-term effects from calcific tendonitis. Chronic pain, reduced mobility, and ongoing discomfort can significantly impact daily activities and quality of life. If left untreated, calcific tendonitis can lead to permanent damage to the shoulder joint and surrounding tissues, resulting in chronic pain and functional limitations.

Case Study: Successful Recovery

A 50-year-old patient with calcific tendonitis underwent a combination of physical therapy and prolotherapy. After three months of treatment, the patient reported a significant reduction in pain and improved shoulder function, allowing a return to normal activities. This case highlights the effectiveness of a comprehensive treatment approach.

Factors Influencing Long-Term Outcomes

Several factors can influence the long-term effects of calcific tendonitis:

• Severity of the Condition: More severe cases may lead to greater long-term complications.
• Age: Older individuals may experience slower recovery and more significant long-term effects.
• Adherence to Treatment: Following prescribed treatment plans can improve outcomes.
• Lifestyle Choices: Maintaining a healthy weight and engaging in regular exercise can support recovery and reduce long-term effects.

The Importance of Early Intervention

Taking action early when dealing with calcific tendonitis can make a significant difference in your recovery and long-term outcomes. Early intervention with conservative treatment options—such as physical therapy, pain medication, and steroid injections—can help relieve pain, reduce inflammation, and restore function before more serious complications develop. In cases where conservative measures are not enough, surgical treatment options may be recommended to relieve pressure on the tendon and stabilize the shoulder. Working closely with a physical therapist can help you develop a personalized plan that includes strengthening exercises, stretching, and pain management techniques tailored to your needs. By addressing calcific tendonitis early, you can improve your chances of a full recovery and reduce the risk of chronic pain or permanent damage.

Preventing Further Complications

Preventing additional problems from calcific tendonitis requires a proactive and comprehensive approach. Maintaining a healthy weight reduces stress on the tendon, while avoiding improper lifting techniques can help prevent further injury. Incorporating regular exercise, especially strengthening exercises and stretching, supports tendon health and helps reduce the risk of future injuries. By working with your healthcare team and making positive lifestyle changes, you can help relieve pain, support your tendon health, and minimize the risk of long-term issues associated with calcific tendonitis.

When to Seek Medical Help

Seek immediate medical attention if you experience:

• Severe pain that does not improve with rest
• Loss of function in the ankle or foot
• Signs of infection, such as fever or swelling

These may indicate a more serious condition requiring prompt medical intervention.

Frequently Asked Questions

What is calcific tendonitis?

Calcific tendonitis is a condition characterized by the accumulation of calcium deposits in the tendons, leading to pain and inflammation, particularly in the shoulder.

Can calcific tendonitis heal on its own?

Yes, many cases of calcific tendonitis improve with conservative treatments, but some may require more advanced interventions if symptoms persist.

Is surgery necessary for calcific tendonitis?

Surgery is typically reserved for severe cases that do not respond to conservative treatments. Most patients find relief through non-surgical methods.

How effective is prolotherapy for calcific tendonitis?

Prolotherapy has shown promising results in reducing pain and promoting healing in patients with calcific tendonitis, especially when combined with other conservative treatments.

Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call

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Author Bio

Having performed over 10,000 procedures, Mr. Eaton is one of the UK’s leading practitioners in the field of treating calcific tendonitis, with patients traveling to see him from across the UK, Europe, and the Middle East.

With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with calcific tendonitis and providing effective treatment options to alleviate them.

He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.

Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.

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References

1. 1. National Institute of Neurological Disorders and Stroke. (2023). Herniated Disc. https://www.ninds.nih.gov/health-information/disorders/herniated-disc
   2. Harvard Health Publishing. (2022). Herniated disk: What you need to know. https://www.health.harvard.edu/pain/herniated-disk-what-you-need-to-know
   3. Chou, R., et al. (2018). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline. Annals of Internal Medicine, 168(7), 514-530.
   4. Rabago, D., et al. (2016). Prolotherapy in Primary Care Practice. Primary Care: Clinics in Office Practice, 43(2), 329-338. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913113/